Primary antiphospholipid syndrome presenting as renal vein thrombosis and membranous nephropathy

Pediatr Nephrol. 2011 Jun;26(6):979-85. doi: 10.1007/s00467-011-1787-z. Epub 2011 Mar 23.

Abstract

Antiphospholipid syndrome is a multisystem auto-immune disorder characterized by thrombotic events and the presence of circulating antiphospholipid antibodies. Large vessel involvement in the form of thrombosis/stenosis and thrombotic microangiopathy is a commonly described renal finding. However, non-thrombotic glomerulopathies are increasingly being recognized in patients with antiphospholipid syndrome. We report a rare occurrence of both renal vein thrombosis and membranous nephropathy in a previously healthy adolescent male. Investigations revealed persistently positive antiphospholipid antibodies in the absence of an underlying systemic autoimmune disorder or malignancy. Our patient responded favourably to anti-proteinuric therapy and anticoagulation with complete resolution of proteinuria and a nearly occlusive thrombus.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Antiphospholipid Syndrome / diagnosis*
  • Antiphospholipid Syndrome / drug therapy
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Glomerulonephritis, Membranous / complications
  • Glomerulonephritis, Membranous / diagnosis*
  • Glomerulonephritis, Membranous / drug therapy
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Renal Veins / pathology*
  • Thrombotic Microangiopathies / complications
  • Thrombotic Microangiopathies / drug therapy
  • Thrombotic Microangiopathies / pathology
  • Treatment Outcome
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnosis*
  • Venous Thrombosis / drug therapy

Substances

  • Anti-Bacterial Agents
  • Anticoagulants
  • Glucocorticoids